0 INSTITUT PASTEUR~ELSEVIER Paris 1997 Res. Virol. 1997, 148, 139-142 Liver cirrhosis: epidemiological aspects in Italy C. De Bat (*), C. Clementi, F. Duca, D. Livoli, G. Poliandri, A. Bozza, A. Osso, S. Martuscelli, C. Pasquazzi, P Petrucci, C. Furlan and G. Taliani Department of Infectious and Tropical Diseases, University of Rome “LA Sapienza “, Rome SUMMARY In order to improve our knowledge of the incidence of liver cirrhosis in Italy, we conducted two epidemiological studies. The first study showed that about 15% of asymptomatic subjects with persistent increase in alanine aminotransferase had histological evidence of cirrhosis. In this setting, cirrhosis was associated with viral aetiology in 91.4% of cases. In the second study, which enrolled cirrhosis patients from 13 centres from all regions of the country, viral infections were detected in 82.6% of patients, the large majority of whom, 71.2%, were positive for hepatitis C virus (HCV). Alcohol abuse was present in 8.7% of cases as exclu- sive aetiological factor. All the patients were classified according to Child-Pugh and were scored as class A in 62.4%, as class 6 in 23.8% and as class C in 13.8 % of cases. The age distribution showed that about 55% of cirrhosis patients were under 60 years of age; 34.3% of them had a Child-Pugh score of class B or C. These data show that HCV infection represents the predominant aetiological factor of cirrhosis in Italy and that cirrhosis can be found frequently in asymptomatic subjects. Key-words: Hepatitis, HBV infection, HCV infection, Cirrhosis; Epidemiology, Italy. INTRODUCTION POPULATIONS AND TESTS In Italy, because of the high prevalence of hepa- titis B and C chronic viral infections, which affect l-3 % of the population over the age of 30 years, cirrhosis is on the increase. In the majority of cases, graded as Child-Pugh class A (Child, 1964), the absenceof signs of portal hypertension may lead to missing the diagnosis unless specific exams are per- formed. Therefore, the prevalence of cirrhosis of viral origin in Italy could be higher than that reported ; further epidemiological studies may thus be of great value. During the last three years two different studies were conducted. The first was a study of 983 con- secutive patients with persistent increase in alanine aminotransferase (ALT) level, observed in our Department. All patients underwent ecotomo- graphic-aided liver biopsy by Hepafix 1.6 or Surecut 16G needles. Diagnostic evaluation of aetiologic factors associated with the liver disease was also performed in all cases. Histologic diagnosis was made, by one person, according to Scheuer (Scheuer, 1991). Received November 5, 1996. (*) Corresponding author: Carlo De Bat, Department of Infectious and Tropical Diseases, “La Sapienza” University, Viale de1 Pol- iclinico 155, 00161 Rome, Italy.